Despite the recognized importance of chronic kidney disease (CKD), the United States currently lacks a comprehensive, systematic surveillance program that captures and tracks all aspects of CKD in the population. As part of its CKD Initiative, the Centers for Disease Control and Prevention (CDC) funded two teams to jointly initiate the development of a CKD surveillance system. Here, we describe the process and methods used to establish this national CDC CKD Surveillance System. The major CKD components covered include burden (incidence and prevalence), risk factors, awareness, health consequences, processes and quality of care, and health system capacity issues. Goals include regular reporting of the data collected, plus development of a dynamic project web site and periodic issuance of a CKD fact sheet. We anticipate that this system will provide an important foundation for widespread efforts toward primary prevention, earlier detection, and implementation of optimal disease management strategies, with resultant increased awareness of CKD, decreased rates of CKD progression, lowered mortality, and reduced resource utilization. Final success will be measured by usage, impact, and endorsement.